Tots FAQs - Therapists

What age patients benefit from Tots?

Birth to 100

Tots is appropriate for anyone else of any age that would benefit from assistance to guide them through the motions. Any patient requiring assistance or hands on cues to assess and perform motions due to age, intellectual challenges, limitations In body awareness from infant to geriatrics. While Tots was initially developed for children, the concept has expanded to benefit “kids” of all ages up to 99. It is especially beneficial for older adults with pain or poor body awareness as well as adults with intellectual challenges.

Is TMR based on science?

TMR is cutting edge science based on the most recent advances in understanding the effect of manual care on soft tissue down to the cellular level. Numerous studies have been published in peer reviewed journals on the effectiveness of TMR. See resarch link in the menu bar for TMR Tots poster presentations.

How do TMR and TMR Tots differ?

• Total Motion Release (TMR) is an innovative systematic for assessment and treatment based on a modified Stain Counterstrain concept which is utilized by physical and occupational therapists, speech pathologists, and athletic trainers. The original TMR system was developed to identify areas of hypo-mobility causing pain and limitations in in postural symmetry, range of motion, respiration elsewhere in the body Utilizing a quick screening tool, the therapist teaches the patient to identify areas of restricted mobility and self treat to resolve issues by moving into directions of ease and comfort. By testing the whole body and treating the symptomatic area indirectly key restrictions may be identified which would otherwise limit results. The has been used in a wide variety of adult orthopedic diagnoses from sports injuries, back pain to joint replacements.

• TMR Tots & Teens was developed for patients & clients of all age groups (0-99) Originally designed for teaching caregivers and consulting in pediatric settings, the Tots & Teens version has been found to be applicacable to patients of all ages with limitations in body awareness or ability to follow cues to exercise due to age, intellectual delays, pain or neurological issues. Tots & Teens has been called the prep work for all you do as a therapist The first goal is achievement of postural symmetry as a foundation for optimal motor control & pulmonary function. Later the same systematic assessment of asymmetries may be applied to organize a concise care plan to indirectly develop motor control using evidence based principles of neuroplasticity.

• Rather than working on a skill ie; apparent left upper extremity neglect limiting motor control, the systematic assessment might identify limited transverse plane rotation to the right at ribs 7-10. This hypomobility may limit respiration for speech, change the midline for function for right hand use such as placement of paper on desk in classroom, and move the left upper extremity out of the line of vision, limiting access to the left upper extremity to develop motor control

• Using the same total body assessment system the therapist guides or assists the patient to identify directions of ease. The system records a patient’s strengths as well as needs to identify discrete improvements in functional outcomes.

• Tots is a hands on guided version of TMR/Patients that do not have the body awareness to be able to follow cues to self assess, those with intellectual disabilities, patients with extreme pain that are afraid the move, and developing infants and children benefit from guided TMR . While Tots was initially developed for pediatrics it was found to be equally beneficial for anyone needing assistance in assessment & treatment and. That Includes “kids” or “teens” of all ages up to 99!

• TMR primarily helps a patient resolve pain, restore function, return to ADLs (get back on a bike).

• Tots may be used for rehabilitation as well, but primarily is focused on habilitation - simultaneously gaining mobility and a postural foundation to progress with skill development (learning to ride the bike).

What TMR Tots Classes Are Offered?

Do I register for the Tots 1 or Tots 1 & Tots 2 package?

Register for the Tots 1&2 package to learn the complete Tots Concept and save 1/2 price on a future Tots 2. Each class is 16 hours so you will get a total of 32 hours (32 CEU's) training with this discount.

Your credit is kept for when you are ready to level up to Tots 2. Just pick the date of your choice and click the link that says already paid to register!

A. Tots 1, Level 1 – Intro to Tots – 16 Hours

a. Live Streamed Online or Live Onsite

b. Free unlimited Online retakes Online; 1/2 price ($300) for Onsite retakes – Space Permitting Onsite

c. Free Access To Prerecorded Class To Review

d. Covers the basic principles to begin using the Tots concept immediately following the class.

B. Tots 1, Level 2 - Intermediate - 16 hours (Pre-requisite: Tots Level 1), 16 Hours

a. Live online only (unless privately hosted class)

b. Taken 6-18 Months Apart

c. Complete learning the Tots Concept - mandatory for treatment of complex cases and utilizing the the concept in transitions and home programs using motor learning principles

d. Repeat Level 1 live, online, or with the Home Study recommended for best preparation.

C. Level 3 - Mastery Workshop - 16 Hours (Pre-requisite Levels 1 & 2)

a. Brainstorming & Treatment of Complex Patients

b. Assist in assessment and treatment to refine your skills

c. mastering the application with most complex cases of CP

d. Explore how peers may layer of additional tools and strategies on top of a TMR foundation

e. Preparation for Certification

What is the difference between Level 1 & Level 2 TMR Tots?

A. Level 1 provides basic instruction in the 10-step protocol,

a. The 3 components of TMR: Release, Activate, & Organize

b. Development of basic home programs

c. Treatment with simple one plane motions

d. Introduction to the functional limitation checklist

e. How to treat 2 of the 10 grades of torticollis

Advancing to Tots Level 2 - Some people are ready to advance sooner than later. It is recommended that you either take Tots 1 online again or review the pre-recorded class before attending Level 2. However, if you have purchased both classes and wish to attend Level 2 before taking the class for credit, you may audit the class.

B. Level 2 includes

a. Treatment in multi-planar motions more applicable to therapeutic play activities

b. Progression through a decision tree for accelerating progress and/or working with challenging patients. It is recommended that you either take Tots 1 online again or review the pre-recorded class before attending Level 2. However, if you have purchase both classes and wish to attend Level 2 before taking the class for credit, you may audit the class.

c. Varying positions of assessment and treatment for medical or developmental challenges

d. The additional 8 more complex grades of torticollis

e. Applying the protocol to motor control using cross-education and interconnection of strength through the entire body

What are my options to attend a course?

a) Seminars are streamed online to accommodate a wide variety of schedules and time zones. Online courses are offered on 2 consecutive weekends - Saturday/Sunday

b) The onsite classes are 16 hours 2 consecutive days, typically Saturday/Sunday 8 hours/day x 2 days = 16

c) Online courses are offered 2 consecutive weekends - Saturday/Sunday 4 hours each day x 4 = 16 to accommodate families needing shorter days. The 1st weekend is considered Day 1 and the 2nd weekend is considered Day 2 of the course.

d) If you can't stream 2 consecutive weekends, you may take the first weekend and complete the 2nd weekend at a later date. Once you have completed all 4 sections, your CEU certificate will be dated for the date of the class that you finish the course.

I’m not in Continental USA. How can I attend from overseas?

a) Alaska and Hawaii participants can attend Friday & Saturday afternoon/evening for 4 hours on 2 consecutive weekends

b) European participants can attend Saturday and Sunday afternoon/evening for 4 hours on 2 consecutive weekends since classes are streamed from the New York (Eastern USA time zone)

c) Asian, Australian, and New Zealand participants can attend on Saturday & Sunday mornings or afternoons for 4 hours on 2 consecutive weekends since classes are streamed Fri & Sat evenings from the New York (Eastern USA time zone).

d) Special group and 1:1 class arrangements can be made with the instructor for International students wishing to take Tots 3 who are unable to travel to North America.

What if my faith limits the days I can attend?

a) Onsite courses are offered on 2 consecutive weekdays when faith limits weekend attendance. Streaming options are available on the website. Look for the dates that have the course on Thursday and Sunday mornings

b. If the course schedule does not accommodate your observance, please contact Susan to discuss training options.

Is It necessary to attend a class in person?

Tots 1 classes are offered both onsite an online to meet your learning style

Save your travel expenses as you learn Tots in your PJs! But you are also welcome to come to an onsite course to meet you in person.

a) All labs are done using a soft 18" to 20" baby doll as well as feeling the exercises on yourself during the lab portions of the class so that streaming Tots 1 can be just as beneficial as an in person class.

b) Tots 2 is offered online with participants doing labs with the live feed. Occasionally, in person classes are privately hosted. The class has been successfully streamed to 6 continents.

c) Tots 3 is a mastery course and is 90% lab work with hands-on feedback for advanced skills. Participants actively evaluate and assist in the treatment of complex patients.The class is held several times a year in person only. There is a separate $595 registration fee for this class and $300 for retakes.

What if I need don't need CEU's now for my license renewal?

a) Because online retakes are FREE, you will get a new certificate each time you take the class. Therefore, take it again when you need those 16 hours and just use the new certificate from that class for your license renewal.

If I attend online, can I retake in a class in person?

Online retakes are always free. In-person retakes are $300 depending on space limitations. New participants have priority registering for an onsite course. Confirm availability with the instructor before booking non-refundable travel arrangements.

How long do I have to take the courses if I purchase a package?

That is totally up to you and the pace at which you wish to learn. Typical participants complete the prerequisite retake of Level 1 (video, in-person or online) in 3-6 months and progress to Level 2. Others may take a year or more solidifying their skill set. There is no time limit but if you need to take a significant break between levels, please retake the class again before adding strategies so that you are ready to hit the ground running. Just go on the website to register for your preferred date when you are ready and click already registered.

How to do I get started when online dates do not fit my schedule?

Don’t wait on helping your clients! Get a jump start learning Tots by registering for a future class and watching the fully recorded class now! Your registration for a class includes 4-week access to home study videos. Request the free video again and again and then take the course for credit online or onsite when your schedule allows.

Can I change my dates for classes?

Of course! Life happens and you will be given full credit toward a future class.

b) You can either reschedule or TMR will hold your credit until you can attend.

Note: Onsite classes are quickly SOLD OUT with wait lists. Please notify us ASAP if you are unable to attend an in-person course to enable someone else to come that is hoping for a spot.

Are the seminars approved for continuing educations credits?

a) Yes. Seminars are approved by AOTA for OTs & COTAs, NCBTMB for LMTS, State PT Boards and PT. Associations, CE Broker for FL, and. Illinois Early Intervention special requirement for pediatric therapists. Click here to see approvals by states. Click here to see approvals by states

b) Both onsite & live online courses are considered for LIVE credit since they are interactive. As you participate in labs during streamlined courses you can be viewed on zoom to allow instructor to provide feedback. During lectures microphones and chats are opened for questions and discussion.

c) Because you are providing video proof (Zoom video on) of your attendance at a live streamed course and that you are actively participating in the course. The moderator reviews the video feeds at intervals determined by them.

d) Those participating online must scan or photograph their homework at the end of each day. The forms are uploaded to a website to be reviewed by the instructor and a certificate is downloaded to the email you provided within the following week.

Click here to see approvals by states

How do I become certified in TMR Tots?

1) Demonstrate handling with listening skill to follow and guide patient generated treatment at a Level 3 class.

2) Practical examination: Demonstrate treatment on a complex client you worked with. Complete the Advanced Care Plan for that client, discussing the treatment and progress to date, current plan, and future plan utilizing TMR.

3) Successfully passing a Written examination

NOTE: Certification is valid for 5 years. It can be extended indefinitely by active participation in the TMR Tots Facebook group, other online discussion groups, attending free retakes of classes to stay current with updates in TMR Tots, and/or assisting as a TA in onsite classes.

What is the difference between coaching & consults with instructor?

a) Coaching (Free) - Free post course follow up via zoom, email, or by phone is included in your registration. This allows the instructor opportunities to support the participant in understanding and implementing the course material. Coaching provides an opportunity bring your question or challenges and share successes. Hours are planned to accommodate various time zones and schedules.

b) Consults (Fee based) - Observation of the treating therapist by the instructor as they work with an individual client during a therapy session. Most beneficial for challenging cases to brainstorm and offer assessment and treatment ideas

How do I access the pre-recorded class

The Home Studies are a pre-recorded class for you to review at your own pace over a 4 week period. A link is sent to you by email when you request them from the instructor at tmrtots@gmail.com. Please indicate when you registered or took the class to confirm eligibility. When the link expires, you may request access again.

NOTE: Certificates are not provided for using the Home Study guide